Surgical Failure and Revision Strategy for Atlantoaxial Dislocation

Author:

Ma Xiangyang123,Zou Xiaobao1,Chen Zexing12,Yang Haozhi1,Chen Junlin12,Ma Rencai13,Fu Suochao1,Xia Hong1

Affiliation:

1. Department of Orthopedics, General Hospital of Southern Theatre Command of PLA, 111 Liuhua Road, Guangzhou, 510010, People’s Republic of China

2. The First School of Clinical Medicine, Southern Medical University, No.1838 North of Guangzhou Road, Guangzhou, 510515, People’s Republic of China

3. Guangzhou University of Chinese Medicine, No.232 Waihuan East Road of Guangzhou University Town, Guangzhou, 510006, People’s Republic of China

Abstract

Study Design. Retrospective study. Objective. To classify surgical failures following atlantoaxial dislocation, present strategies for revisions and evaluate the clinical results of revision surgery. Summary of Background Data. With the increase in atlantoaxial dislocation surgery, the number of surgical failures has gradually risen. However, current reports on atlantoaxial surgical revision are limited in scope. There remains a lack of summary regarding the causes of surgical failure, a detailed classification system, and no proposed strategy for revision surgery. Methods. 109 cases of failed surgery following atlantoaxial dislocation were classified according to the reduction immediately after surgery and the fusion status before revision. The reduction, decompression, fusion status and outcomes following revision surgery were evaluated by X-ray, CT, MRI and JOA score. The data were analyzed statistically with a paired-samples t test and multivaraible logistic regression analysis. Results. The 109 patients were classified into three categories of failure: non-reduction with non-fusion (NR-NF, 73 cases), non-reduction with fusion (NR-F, 19 cases), and reduction with non-fusion (R-NF, 17 cases). Sixty-four patients underwent anterior revision, 21 posterior revision, and 24 anteroposterior revision. Postoperative complications were the primary cause of early revisions. After revision, complete decompression was achieved in all cases, anatomical reduction in 89 cases, significant improvement of JOA score in 77 cases, and fusion achieved in 86 cases. Twelve cases experienced surgical complications and 3 underwent a second revision. Conclusions. We found that NR-NF was the most common type of failure following surgery for atlantoaxial dislocation. Revision strategies can be guided according to our descriptive classification of failure, and revision surgery should focus on achieving adequate reduction, appropriate fixation and reliable fusion to optimize post-surgical outcomes.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Orthopedics and Sports Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3